MedlinePlus Medical Encyclopedia: Opisthotonos

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Opisthotonos

Contents of this page:
Definition Considerations Common Causes	Home Care Call your health care provider if What to expect at your health care provider's office

Definition

Opisthotonos is an abnormal posturing condition characterized by rigidity and severe arching of the back, with the head thrown backwards. This is such that if a person were laid on his or her back, only the back of the head and the heels would touch the supporting surface.

Considerations

Opisthotonos may occur in meningitis in infants, and it is a sign of irritation of the membranes surrounding the brain and spinal cord (meninges). It may occur as a posture reflective of depressed brain function or injury to the nervous system.

Opisthotonos is much more common in infants and children than in adults. It is also more exaggerated in infants and children. This is a reflection of the relative immaturity of their nervous systems.

Common Causes

Meningitis
Arnold-Chiari syndrome
Subarachnoid hemorrhage
Tetanus
Brain tumor
Severe head injury
Glutaric aciduria and organic acidemias
Gaucher disease
Krabbe Disease
Achondroplastic dwarfism (occasionally)

Drugs, particularly phenothiazines and other antipsychotic medications, can cause a side effect known as acute dystonic reaction. Opisthotonos may be part of this reaction.

Home Care

Hospital care is required for a person who develops opisthotonos.

Call your health care provider if

Go to the emergency room, or see your physician immediately if this symptom occurs! Typically, however, opisthotonos is a symptom that follows late in the course of other conditions which are serious enough that medical attention will already have been sought.

What to expect at your health care provider's office

This condition will be evaluated in a hospital setting. Emergency measures will be taken as appropriate.

The medical history will be obtained, and a physical examination will be performed.

Medical history questions documenting opisthotonos in detail may include:

When did this behavior start?
Is it always the same type of posturing?
What other symptoms preceded or accompanied the abnormal posturing (particularly fever, stiff neck, headache, but also any others)?
Is there any significant medical history (such as a recent illness)?

The physical examination will include a complete assessment of the nervous system.

The cause of the opisthotonos will be suggested by the history and physical examination. Diagnostic tests may include:

Lumbar puncture and analysis of the cerebrospinal fluid (CSF culture, CSF cell counts, and similar studies), electrolyte analysis
CT scan of the head
MRI of the head
Blood and urine tests

Update Date: 10/23/2003

Updated by: Elaine T. Kiriakopoulos, M.D., M.Sc., Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.

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